Female Urinary Incontinence
Treatment of female stress urinary incontinence (loss urine during activities, walking, running, coughing, sneezing, etc.) can range from conservative treatments to surgical treatment. This is often due to urethral hypermobility in which urine leaks out during sudden increased abdominal pressure as the urethra does not have the proper support to neutralize sudden changes in pressure. If conservative treatments such as weight loss, Kegel exercises, pelvic floor physical therapy, then patients have a range of surgical options. Many surgical options are too invasive and have less than satisfactory outcomes. Frankly, many belong in pages of old Urogynecology books and have only historical significance. For the past two decades, mid-urethral sling has become the gold standard. Approaches include Transobturator and Transvaginal technique. They have 94-96% success rate in the right patient to prevent further stress incontinence. Procedure is outpatient and you can return to normal activities in 1-2 weeks with minimal restrictions. Dr. Tajkarimi is the most experienced female stress incontinence urologist in Northern Virginia, with more than 500 successful female sling procedures in the past 16 years. If you also suffer from urinary incontinence, see Dr. Tajkarimi. This type of procedure must be performed by an experienced surgeon for best outcome and prevention of complications, which can range from urinary retention, persistent incontinence, bladder injury, and mesh erosion. These complications are quite rare in the hands of experienced female pelvic floor surgeons.
Effective Treatment for Women with Urinary Urgency & Leakage
Botox has been used to treat urinary incontinence for many years. It acts to decrease the muscular contractions of the bladder. These bladder “spasms” can arise from routine overactive bladder, which commonly occurs in women with aging or they can be more serious in patients with neurogenic bladder from neurologic disease or injury. Bladder spasticity has a lot of different names; it is also called overactive bladder, detrusor overactivity, detrusor hyperreflexia, and neurogenic bladder.
HOW IS BOTOX ADMINISTERED? Botox needs to be injected into the muscle of the bladder. This is done in the clinic or operating room. First the bladder is flushed with a local anesthesia, via a catheter, which is allowed to thoroughly numb the bladder. Then a scope is passed up the urethra (urine channel) into the bladder. A small needle is placed through the scope and several injections are made into the bladder designed to spread Botox throughout the muscle of the bladder. Most patients tolerate this procedure well.